Cannabinoids for Chronic Pain: Translating Systematic Review Findings Into Clinical Action
Authors: Kevin F. Boehnke, Daniel J. Clauw
Journal: Annals of Internal Medicine (2022)

EditorialsAugust 2022Cannabinoids for Chronic Pain: Translating Systematic Review Findings Into Clinical ActionKevin F. Boehnke, PhD and Daniel J. Clauw, MDKevin F. Boehnke, PhDAnesthesiology Department, University of Michigan Medical School, Ann Arbor, Michigan and Daniel J. Clauw, MDAnesthesiology Department, University of Michigan Medical School, Ann Arbor, MichiganAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M22-1512 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In their article, McDonagh and colleagues (1) report a systematic review of placebo-controlled trials and cohort studies to investigate the benefits and harms of cannabinoids for treatment of chronic pain. They categorized cannabis products by delta-9-tetrahydrocannabinol (THC) to cannabidiol (CBD) ratio, route of administration (oral, topical, or sublingual), and source (plant based, synthetic, or extract). Overall, use of comparable THC-to-CBD ratio products (1.1:1) and synthetic, high THC-to-CBD ratio products were generally associated with small improvements in pain severity and increased risk for sedation and dizziness. These effects were primarily seen among patients with chronic neuropathic pain, as studies of patients ...References1. McDonagh MS, Morasco BJ, Wagner J, et al. Cannabis-based products for chronic pain. A systematic review. Ann Intern Med. 2022;175:1143-53. doi:10.7326/M21-4520 LinkGoogle Scholar2. O'Grady C. Cannabis research database shows how U.S. funding focuses on harms of the drug. Science. 27 August 2020. Accessed at www.science.org/content/article/cannabis-research-database-shows-how-us-funding-focuses-harms-drug on 10 May 2022. Google Scholar3. Boehnke KF, Gangopadhyay S, Clauw DJ, et al. Qualifying conditions of medical cannabis license holders in the United States. Health Aff (Millwood). 2019;38:295-302. [PMID: 30715980] doi:10.1377/hlthaff.2018.05266 CrossrefMedlineGoogle Scholar4. Reid M. A qualitative review of cannabis stigmas at the twilight of prohibition. J Cannabis Res. 2020;2:46. [PMID: 33526147] doi:10.1186/s42238-020-00056-8 CrossrefMedlineGoogle Scholar5. Dahlgren MK, Sagar KA, Lambros AM, et al. Urinary tetrahydrocannabinol after 4 weeks of a full-spectrum, high-cannabidiol treatment in an open-label clinical trial [Letter]. JAMA Psychiatry. 2021;78:335-337. [PMID: 33146684] doi:10.1001/jamapsychiatry.2020.3567 CrossrefMedlineGoogle Scholar6. Nutt D, Bazire S, Phillips LD, et al. So near yet so far: why won't the UK prescribe medical cannabis. BMJ Open. 2020;10:e038687. [PMID: 32958492] doi:10.1136/bmjopen-2020-038687 CrossrefMedlineGoogle Scholar7. MacCallum CA, Russo EB. Practical considerations in medical cannabis administration and dosing. Eur J Intern Med. 2018;49:12-19. [PMID: 29307505] doi:10.1016/j.ejim.2018.01.004 CrossrefMedlineGoogle Scholar8. Bhaskar A, Bell A, Boivin M, et al. Consensus recommendations on dosing and administration of medical cannabis to treat chronic pain: results of a modified Delphi process. J Cannabis Res. 2021;3:22. [PMID: 34215346] doi:10.1186/s42238-021-00073-1 CrossrefMedlineGoogle Scholar9. Sihota A, Smith BK, Ahmed SA, et al. Consensus-based recommendations for titrating cannabinoids and tapering opioids for chronic pain control. Int J Clin Pract. 2021;75:e13871. [PMID: 33249713] doi:10.1111/ijcp.13871 CrossrefMedlineGoogle Scholar10. Boehnke KF, Scott JR, Litinas E, et al. Pills to pot: observational analyses of cannabis substitution among medical cannabis users with chronic pain. J Pain. 2019;20:830-841. [PMID: 30690169] doi:10.1016/j.jpain.2019.01.010 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Anesthesiology Department, University of Michigan Medical School, Ann Arbor, MichiganDisclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M22-1512.Corresponding Author: Daniel J. Clauw, MD, Anesthesiology Department, University of Michigan Medical School, 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48106; e-mail, [email protected]umich.edu.This article was published at Annals.org on 7 June 2022. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCannabis-Based Products for Chronic Pain Marian S. McDonagh , Benjamin J. Morasco , Jesse Wagner , Azrah Y. Ahmed , Rongwei Fu , Devan Kansagara , and Roger Chou Metrics August 2022Volume 175, Issue 8Page: 1191-1192KeywordsAnalgesicsCannabinoidsCannabisCannabis usePain ePublished: 7 June 2022 Issue Published: August 2022 Copyright & PermissionsCopyright © 2022 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...